| National Provider Identifier [NPI]: | 1790851509 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 JACKSON STREET |
| Street Address 2 Of The Provider | SUITE 111 |
| City Of The Provider | ANDERSON |
| Zip Code Of The Provider | 46016 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 4390 |
| Number Of Medicare Beneficiaries | 951 |
| Total Submitted Charge Amount | 459209 |
| Total Medicare Allowed Amount | 294666.55 |
| Total Medicare Payment Amount | 215752.97 |
| Total Medicare Standardized Payment Amount | 212254.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 296 |
| Number Of Medicare Beneficiaries With Drug Services | 231 |
| Total Drug Submitted ChargeAmount | 6900 |
| Total Drug Medicare AllowedAmount | 3779.43 |
| Total Drug Medicare PaymentAmount | 3634.46 |
| Total Drug Medicare Standardized Payment Amount | 3634.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 4094 |
| Number Of Medicare Beneficiaries With Medical Services | 951 |
| Total Medical Submitted Charge Amount | 452309 |
| Total Medical Medicare Allowed Amount | 290887.12 |
| Total Medical Medicare Payment Amount | 212118.51 |
| Total Medical Medicare Standardized Payment Amount | 208620.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 267 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 537 |
| Number Of Male Beneficiaries | 414 |
| Number Of Non Hispanic White Beneficiaries | 885 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 696 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 255 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4765 |